Surgical ligature and means for applying the same



Apr. 17, 1923. 1,452,373

J. s. GdMEz SURGICAL LIGATURE AND MEANS FOR APPLYING THE SAME Filed Oct. 15, 1921 2 Sheets-Sheet 1 V. E QQQ i I i 1 J2 23 50 1 27 zo 21 2 Whore I c aga/h mmaz 62mm Apr. 17,1923. 1,452,373

' J. 5. GdMEz SURGICAL LIGATURE AND MEANS, FOR APPLYING THE SAME Filed Oct. 15, 1921 2 Sheets-Sheet 3 Patented Apr. 17, 1923.

UNITED STATES JOAQUIN SANCHEZ GOMEZ, or WASHINGTON, DISTRICT or COLUMBIA.

SURGICAL LIGATURE AND MEANS FOR APPLYING THE Application filed. October 15, 1921. Serial No. 507,887.

To all whom it may concern:

Be it known that I, JOA UI SANoHnz GoMnz, a subject of the King of Spain, residing at Washington, District of Columbia, have invented. certain new and useful Improvements in Surgical Ligatures and Means for Applying the Same, of which the following is a specification.

This invention relates to surgical appliances and has special reference to a metallic ligature and forceps for applying the same.

One important object of the invention is to provide means for ligaturing wounds in the human body and that of animals, the

ligatureused being preferablyformed of absorbable material.

I Another important object of the invention is to provide an improved form of clip constituting the ligature,the clips being complementary so that they look together solidly in forming the ligature.

A third important object of the invention is to provide an improved form of ligature for use in organic tissues which will act to hold the margins of a wound closely together. i

A fourth important object of the invention is to provide an improved forceps for applying ligatures of this description.

A, fifth important object of the invention is to provide a surgical forceps for use in connection with clips of this description which will have its jaws equipped with a magazine and a single feed mechanism so that a number of the' clips can be held by the forceps and fed into position therefrom one by one. 7

A sixth important object of the invention is to provide an improved forceps of this character wherein the operation of closing the forceps will actuate the said mechanism.

Vith the above andother objects in view, the invention consists in general of certain novel details of construction and combinations of parts hereinafter fully described, illustrated in the accompanying drawings, and specifically claimed/ In the accompanying drawings, like characters of reference indicate like parts in the several views, and

Figure 1 is a perspective view of the complementary forceps as constructed inaccordance with this invention, the instrument being shown open.

Figure 2 is an enlarged detail view with r the instrument closed the better to show the location of the operating wires.

Figure 3 is a detail section with the forceps open on the line 3-3 of Figure 2.

Figure 4 is a detail similar to Figure 3 but with the forceps closed.

Figure 5 is a detail section on the line v5-5 of Figure 3.

Figure 6 is a longitudinal vertical median face on an enlarged scale through one of the forceps :paws.

Figure 7 is a section on the line 7-7 of Figure 6. I

Figure 8 is a detail perspective view showing the magazine bar removed from the forceps. Figure 9 is an end View of one aw of the forceps, one of the clip portions being shown in position for looking with its cooperating clip. a

Figure 10 is a detail section on the line 10-10 of Figure 6.

Figure. 11 is a-de'tail section on the line 11-11 of Figure 6. f v

Figure 12 is a detail section on the line 12-12 of Figure 6, the main bar being removed.

Figure 13 is a view similar to the forward end of Figure 7 but showing the sin gle feed mechanism in the position assumed in feeding one of the clips toward its component in the other jaw.

F igure' 14 is a section on the line 14L 14 of Figure 3. l

Figure 15 is a detail perspective showing single feed mechanismremoved from the Figure 16 is a view showing two of the complementary clips assembled to form the,

Figures 21 and 22 are views showing modified closed constructions.

Figure 23 is a detail view showing the operation of the modified form of single delivery mechanism.

The ligature 11 part of the subject matter of this invention is formed preferably in two portions which when united are of general. quadrangular form with the corners rounded as clearly shown in Figure 16. Each of the clips constitutes a U-shaped member liming a back portion 10 and parallel legs 11. The back portion has its inner surfaces serrated as at 12 and notches 13 are provided on each side of the serration for purposes which will be explained in connection with the action of the forceps. In the form shown in Figure 16 one of the clips has its legs terminating in frusto-conical portions 1 1: which have their surfaces provided with circumferential serrations 15. Each of the legs 10 of the other complementary clip has its end recessed as at 16 and the inner wall of this recess is provided with circijunferential serrations 17 complementary to the serrations 15. For the purpose of allowing ready engagen'ient of the frusto-conioal end 1 1; in the recess 16 the side walls of this recess 16 are slit at 17 and it is to be understood that any desired number of slits may be used. and 7} these may be located in any convenient position. In place of the clip being provided with two of the legs as shown in Figure 1G 'a clip may be utilized which has a back portion ltianct a greater number of legs. as for instance four, as shown in Figure 21. In like manner the legs 11 may be provided with guard members 18 as shown in Figure 22.

Considering now the forceps. The general form of these forceps is that of the usual class of surgical instriunents but in the particular form each jaw of the forceps is provided with a longitudinal channel 20 opening through the view of the jaw forming a point near the base or pivot and of the forceps to the nose, the latter being partly closed by a pair of spaced flange portions 21. lVithin this channel is located the main bar or rod. This magazine bar is provided with an enlarged end 22 pivoted to the side walls of the channel by means of the pivots 23. From the forward. portion of this enlarged end extends a rod 2 1 which. in cross section, is of fornr and size to accon'imodate the clip members previously described. Mounted on this red 24-. and hearing at one end against the enlarged portion 22 is a coil spring 25. The forward end of this coil spring engages a follower plate 26 and on the portion of the rod forward of the follower plate are located the clips which, in the views in the figures of the drawings will be indicated generally by C. This rod erminates in spaced relation to the flanges 21, the space between the end of the rod and said flanges being just sufficient to accommodate one clip and the feeder mechanism. It should be mentionedthat the forward end of the rod is provided at its lower corners with small spurs 27 which serve as stop members for the end clip. i

The enlarged end 22 is provided. on one of its sides with a cam slot 28 wherein engages the pin 29 of a magazine look. This magazine lock, besides the pin, consists of a body portion 30 sliding in a slot 31 formed in the back wall of the respective jaw. This body terminates in a serrated head 32 accessible to the thumb or finger of the operator, the. head sliding in a recess 33 in the outer face of this back wall. From the inner end of the j aw 30 extends a curved arm under surface and arranged to close the ichannel 20 as can clearly be seen by refercnceto the various figures.

Several forms of single delivery or single feed mechanisms may be used in this connec tion and in the form shown in such Figures as 6 7, 10, 13, let, and 15 there is provided a palr of arcuate jaws 36 L-sha-ped in cross section and pivoted at their lower ends or pivots 37 carried by the flanges 21. These jaws have. their upper ends crossed as at 38 and pivoted to these upper ends are links 39 which are united at their free ends by a pivot 40, the latter also connecting with an operating rod or wire 4-1. Referring particularly to Figures 7 and 10 and to Figures 13 and 14 it will be seen that when the links are in the position shown in Figure 7 the jaws 86 will be in the position in Figure 10. This will permit the clip at the end of the magazine to pass forward and engage within the L-shaped portions of the aws 36 from whence it may drop into the position shown in Figure 10, the notches or recesses 13 engaging on the prongs 27. If now the rod or wire 41 be pushed forward the links will assume the position shown in Figure 13 and the aws 36 will be forced inwardly and downwardly as shown in Figure let thus engaging and solidly holding the dropped clips. At the same time this movement of these jaws will cut off the remaining clips. It is to be understood that at the instant that this operation of holding the clip in one of the forceps aws is effected an identical operation takes place 'in the other fortions are cut away to provide cam portions 47 as shown clearly in Figures 3 and-4; and the cam portlons are so arranged that when the latch members come together said cam portions engage the wire ends 4-3 and move them from the position shown in Figure 3to the position shown in Figure 4: thus forcing each of'the rods 41 forward and moving the links from the portion shown in Figure 7 to that shown in Figure 13. By this means the operation of closing the forcepseffects actuation of the single delivery mechanism.

In the form of the device illustrated in Figures 18, 19, 20, and 23 the single delivery mechanism is somewhat modified. En'place of a: longitudinal wire 4L1 there is employed a stiff wire as which is in effect arock shaft and on one end of this wire is carried a single arcuate arm 4E9 L shaped in. cross section and corresponding to thejaws 36. v On the other end of the wire is'an angular portion 50,with a bent end 51, the angular portion being received in a recess 52 in the latch mechanism while the end 51 projects for wardly of said recess. Behind the portions 50 are small leaf springs 53 whichnormally hold these portions outward. In this form when the forceps are closed the latch members 45 come together and the serrations 46- engage the bent ends 51 andipush the same inward thus locking the rocker wire 48 and moving the arm 49 in a manner similar to the movement previously described of the arms 36, the initial and final conditions of.

the arm 49 being clearly illustrated in the dotted and full line positions in Figure 23. There has thus been provided a simple and efficient device of the kind described and for the purpose specified.

It is obvious that minor changes may be made in the form and construction of the invention without departing from the material principles thereof. It is not therefore desired to confine the invention to the exact form herein shown and described but it is wished to include all such as properly come within the scope claimed.

- Having thus described the iHV8l'ltlO11,Wl1tb is claimed as new, is z- 1. A surgical ligature consisting of a pair of clips each separate from the other and each having a back portion and legs extending therefrom in parallel relation, the legs of each clip being provided with locking means cooperating with thelegs of the other clip. I

2. A. surgical ligature comprising a pair of clips each, havingparallel spaced legs, the legs on one clip. being tubularat their ends and the legson the other clip being of proper size to engage in said tubular ends. 3. A surgical ligature comprising a pair of clips each having-parallel spaced legs,

the legs on one clip being tubular at their ends and the legs on the other clip being of proper size to engage in said tubular ends, the contacting surfaces of said legs being transversely serrated.

4:. A surgical ligature comprising a pair of clips each having parallel spaced legs, the legs on one clip being tubular attheir ends and the legs on the other clip being of proper size to engage in saidtubular ends, the contacting surfaces of said legs being transversely serrated, and the tubular leg ends being longitudinally split to provide spring aws. e

5. A surgical forceps for applying interlocking Clip ligatures and including a pair of jaws movable toward and from each other, means carried by each jaw for receiving and holding a series of clips, means urging said clips forwardly of said jaws, and mechanism actuated by the operation of closing the jaws to bring a pair of said clip into interlockin g relation.

6. A surgical forceps for applying interlocking clip ligatures andincluding a pair of jaws movable toward and from each other, a clip magazinein each jaw, and a single delivery mechanism for said clips in each jaw, said mechanism being arranged to bring clips inpairs in interlocking relation, and being actuated by the operation of closing said jaws. 1

7. In a forceps of the class described, a jaw having a channel extending longitudinally of its face, a rod in said cl'iannel for carrying a series of clips arranged sideby side, spring means arranged to urge said clips toward the nose of said jaw. a delivery mechanism at said nose arranged to engage tne end clip and move the same vertically out of the channel, and means connected to the delivery mechanism foroperating the same.

8. In a forceps of the class described, a jaw having a channel extending, longitudinally of the face, a rod pivoted in said channel for carrying a series of clips arranged side byside, spring means arranged to urge said clips toward the nose of said jaw, a delivery mechanism at said nose arranged to engage the end clip and move the same vertically out of the channel, means connected to the delivery mechanism for operating the same, and releasable means to lock the rod in position in the channel.

9. In a forceps of the classdescribed, a

jaw havinga channel extending longitudinally of the face, a rod pivoted in said channel for carrying a series of clips arranged side by side, spring means arranged to urge said clips toward the nose of said jaw, a delivery mechanism at said nose arranged to engage the end clip and move the same vertically out of the channel, means connected to the delivery mechanism for operating the same, releasable means to lock therod in position in the channel, and a closure plate carried by the rod and closing the portion of the channel remote from the nose.

10. A surgical forceps comprising a pair of members pivoted intermediate their ends to provide handle and jaw portions, each jaw portion being provided with a clip magazine and a single delivery mechanism, operating rods connected to the single delivery mechanisms and extending through the forceps members into the handle ends thereof, the rear portions of said rods being accessible through the walls of said handle ends, and means'carried by the handle ends to engage and move said rods and thereby effect actuation of the single delivery mechanisms.

11,. A surgical forceps comprising a pair of members pivoted intermediate their ends to provide handle and jaw portions, each jaw portion being channelledlongitudinally, a magazine rod pivoted in each jaw and arranged to carry a series of clips, a spring on's aid magazine rod urging said clips forwardly off the rod, a single delivery mechanism at the forward endof each jaw for feeding the clips one by one toward the opposite jaw, operating rodsconnected to the single delivery mechanisms and extending through the forceps members into the handle ends thereof, the rear portions of said rods rock shaft whereon said arcuate jaw 18:

mounted, said shaft extending into the handle portion of the respective member and having a rock arm at its rear end and means carried by each handle portion for engaging and moving the rock arm in the other handle portion.

13. A surgical forceps comprising a pair of members pivoted intermediate their ends to provide handle and jaw portions, each jaw portion being channelled, a clip magazine in each channel and a single delivery mechanism in each jaw comprising a pair of opposed arcuate jaws each pivoted at one end to the forward end of the forceps jaw, the other ends of said arcuate jaws being connected by knuckle joint links, a rod connected to the central joint of the knuckle joint links and extending rearwardly within the respective handle portion, and means on each of the handle portions to engage the rod on the other handle portion and move the same longiudinally to effect operation of the same longitudinally to effect operation of the knuckle joints.

JOAQUIN SANCHEZ GOMEZ. 

